Device

ABSTRACT

A device  1  to aid advancement of a colonoscope  2  through the colon  3  of a patient comprises an elongate body  4  defining a colonoscope lumen  7 . The body  4  provides a fluid tight seal to the colonoscope  2 . The body  4  has an anchor to releasably anchor the interior wall of a colon  3  to the device to enable a colonoscope  2  to be more easily advanced. The anchor may be provided by suction apertures  8  through which a suction is applied to draw the colon into anchored engagement with the body  4.  The anchor may be provided by a balloon and/or foam based anchoring systems may be provided.

INTRODUCTION

[0001] This invention relates to a device to aid advancement of acolonoscope through a colon. In particular, the invention relates to adevice to aid advancement of a colonoscope through a sigmoid colon

[0002] Conventional colonoscopy procedures involve advancing acolonoscope through the floppy sigmoid colon to the proximal end of thedescending colon.

[0003] However, advancing a colonoscope through the sigmoid colongenerally causes loops to form in the floppy sigmoid colon, andstretches the mesentery to which the sigmoid colon is attached. Thisresults in considerable pain and discomfort for the patient.

[0004] In addition, it is often difficult to advance a colonoscopethrough a colon due to the presence of an obstruction to advancement ofthe colonoscope through the colon, such as a tight bend in the sigmoidcolon, or a protruding piece of the colon wall, or a polyp on the colonwall.

[0005] This invention provides a device to aid advancement of acolonoscope through a colon which is aimed at overcoming at least someof these problems.

STATEMENTS OF INVENTION

[0006] According to the invention there is provided a device to aidadvancement of a colonoscope through a colon, the device comprising:

[0007] an elongate body extending between a proximal end for locationexternally of a colon and a distal end for insertion into a colon;

[0008] the body defining a colonoscope lumen therethrough, and

[0009] an anchor to releasably anchor the interior wall of a colon tothe device.

[0010] In one embodiment of the invention the anchor comprises at leastone suction aperture in the body to draw the interior wall of a coloninto an anchored engagement with the body by suction. The anchor maycomprise a plurality of suction apertures. Preferably the apertures areevenly spaced around the body. Ideally the apertures are evenly spacedalong the body.

[0011] In one case the anchor comprises at least one suction lumen influid communication with the suction aperture. Most preferably thesuction lumen extends proximally from the suction aperture to theproximal end of the body. Ideally the suction lumen is provided by thecolonoscope lumen. Desirably the anchor comprises a source of negativegauge pressure in fluid communication with the suction aperture.

[0012] In another embodiment of the invention the anchor comprises atleast one member which is moveable outwardly into an anchored engagementwith the interior wall of a colon. The member may be expandable into ananchored engagement with the interior wall of a colon. Preferably themember is inflatable into an anchored engagement with the interior wallof a colon. Most preferably the inflatable member comprises a balloon.

[0013] In one case the anchor comprises at least one inflation lumen influid communication with the inflatable member. Most preferably theinflation lumen extends proximally from the inflatable member to theproximal end of the body. Ideally the inflation lumen is provided by thecolonoscope lumen. Desirably the anchor comprises an inflation fluidsource in fluid communication with the inflatable member.

[0014] In one embodiment of the invention the anchor comprises anabsorber. The absorber may be mounted to the elongate body.

[0015] In one case the absorber is biased inwardly. In an alternativecase the absorber is biased outwardly.

[0016] The absorber may be mounted to or comprise the movable member.

[0017] In one embodiment the absorber comprises at least one pad on thedevice.

[0018] In another embodiment the absorber comprises at least one stripextending along the device. The strip may extend substantiallylongitudinally. The strip may extend substantially in a spiral or partthereof.

[0019] In another case the absorber comprises at least one hoopextending around the device. It is believed that such hoop(s) enhancethe anchoring of the interior wall of a colon to the device due to therippled nature of the colon wall.

[0020] The absorber may surround the anchor. Ideally the absorber has aplurality of openings therein. Alternatively the absorber may be acontinuous enclosure around the anchor.

[0021] Preferably the absorber is of a porous material. The porousmaterial may be of an open cell construction, such as a polymericmaterial.

[0022] In a preferred embodiment the device comprises a sleeve toseparate the absorber from the interior wall of a colon during insertionand removal of the device. Ideally the sleeve comprises a movablesheath.

[0023] It is believed that the absorber enhances the anchoring of theinterior wall of a colon to the device.

[0024] It is believed that better traction between the device of theinvention and the interior wall of a colon is achieved by increasing thefrictional forces acting on the surface(s) of contact.

[0025] The sleeve enables the device to be inserted into and removedfrom a colon with less frictional resistance.

[0026] The anchor is preferably provided adjacent the distal end of thebody.

[0027] In a preferred embodiment of the invention the body comprises atleast one seal for sealing between the body and a colonoscope within thecolonoscope lumen. Preferably the seal is a fluid-tight seal. Desirablythe seal is provided at an end of the body. Most preferably the bodycomprises a distal seal at the distal end of the body and a proximalseal at the proximal end of the body.

[0028] In another aspect, the invention provides a colonoscopyapparatus, the apparatus comprising:

[0029] a device according to the invention; and

[0030] a colonoscope defining a proximal end for location externally ofa colon and a distal end for insertion into a colon.

[0031] In one embodiment the colonoscope comprises an insufflation meansat the distal end of the colonoscope to insufflate a colon distally ofthe colonoscope to clear a passage for advancement of the colonoscopethrough the colon. Preferably the insufflation means comprises at leastone insufflation aperture in the colonoscope. Ideally the insufflationmeans comprises at least one insufflation lumen in fluid communicationwith the insufflation aperture. Most preferably the insufflation lumenextends proximally from the insufflation aperture to the proximal end ofthe colonoscope. Desirably the insufflation means comprises aninsufflation fluid source in fluid communication with the insufflationaperture.

[0032] In a preferred embodiment the apparatus comprises a sealing meansto create a fluid-tight seal to the interior wall of a colon proximallyof the distal end of the colonoscope during insufflation. Ideally thesealing means is provided by the anchor.

[0033] According to a further aspect of the invention, there is provideda method of advancing a colonoscope through a colon, the methodcomprising the steps of:

[0034] providing a colonoscope, the colonoscope defining a proximal endand a distal end;

[0035] providing an anchoring device, the anchoring device defining aproximal end and a distal end;

[0036] inserting the distal end of the colonoscope into a colon;

[0037] inserting the distal end of the anchoring device into the colon;

[0038] anchoring the interior wall of the colon to the anchoring device;

[0039] advancing the colonoscope through at least part of the colon; and

[0040] releasing the anchor.

[0041] In one embodiment the method comprises the step of moving theanchoring device proximally to at least partially straighten the colonafter anchoring the interior wall of the colon to the anchoring device.The method may comprise the step of moving the colonoscope proximallyduring the step of moving the anchoring device proximally. The methodmay alternatively comprise the step of maintaining the position of thecolonoscope fixed during the step of moving the anchoring deviceproximally.

[0042] In a preferred embodiment the method comprises the step ofinsufflating the colon distally of the colonoscope to clear a passagefor advancement of the colonoscope through the colon. Ideally the methodcomprises the step of creating a fluid-tight seal to the interior wallof the colon proximally of the distal end of the colonoscope beforeinsufflating the colon. Desirably the seal to the interior wall of thecolon is created by the step of anchoring the interior wall of the colonto the anchoring device.

[0043] In another embodiment the interior wall of the colon is anchoredto the anchoring device by applying suction to draw the interior wall ofthe colon into an anchored engagement with the anchoring device.Preferably the anchor is released by releasing the suction.

[0044] In a further embodiment the interior wall of the colon isanchored to the anchoring device by moving at least part of theanchoring device outwardly into an anchored engagement with the interiorwall of the colon. Ideally the part of the anchoring device is movedoutwardly by inflation. Most preferably the anchor is released by movingthe part of the anchoring device inwardly.

[0045] In a preferred embodiment the method comprises the step ofabsorbing fluid from the colon using the anchoring device.

[0046] In one case the method comprises the step of advancing thecolonoscope through the colon until the distal end of the colonoscopeencounters an obstruction to further advancement of the colonoscopethrough the colon before anchoring the interior wall of the colon to theanchoring device. The colonoscope may be advanced through the colonuntil the distal end of the colonoscope is at the proximal end of thesigmoid colon before anchoring the interior wall of the colon to theanchoring device.

[0047] Preferably at least some of the steps are repeated at least onceto advance the colonoscope through the colon in an incremental manner.Most preferably the location of anchoring of the interior wall of thecolon to the anchoring device progresses successively distally as thesteps are repeated.

[0048] The anchoring device may be passed over the colonoscope. Ideallythe anchoring device is passed over the colonoscope in a sealed manner.

[0049] According to a further aspect of the invention, there is provideda method of advancing a colonoscope through a sigmoid colon, the methodcomprising the steps of:

[0050] providing a colonoscope, the colonoscope defining a proximal endand a distal end;

[0051] providing an anchoring device, the anchoring device defining aproximal end and a distal end;

[0052] inserting the distal end of the colonoscope into a sigmoid colon;inserting the distal end of the anchoring device into the sigmoid colon;

[0053] anchoring the interior wall of the sigmoid colon to the anchoringdevice;

[0054] advancing the colonoscope through at least part of the sigmoidcolon; and

[0055] releasing the anchor.

[0056] In one case the method comprises the step of moving the anchoringdevice proximally to at least partially straighten the sigmoid colonafter anchoring the interior wall of the sigmoid colon to the anchoringdevice.

[0057] In another case, the invention provides a method of straighteninga sigmoid colon. Preferably the method comprises the steps of:

[0058] advancing the anchoring device until the distal end of theanchoring device is at the proximal end of the descending colon tosplint the straightened sigmoid colon; and

[0059] advancing the colonoscope into the descending colon.

[0060] The device of the invention may be used to anchor the interiorwall of a colon to the device. By holding the device in a fixedposition, the colon is also held in a fixed position. It is thus easierto advance a colonoscope through the fixed colon, and lesspain/discomfort will be caused to the patient. In the case of using thedevice to aid advancement of a colonoscope through a sigmoid colon, thedevice prevents loops from forming in the sigmoid colon, and stretchingof the mesentery to which the sigmoid colon is attached is alsominimised.

[0061] The device facilitates the advancement of the colonoscope throughthe colon in an incremental manner with relatively small advancementsteps of the colonoscope and the device through the colon between eachanchoring manoeuvre.

[0062] The device of the invention may also be used to collapse thesigmoid colon of a patient to a reduced, straightened configurationsubstantially without causing stretching of the colon and the mesenteryto which the colon is attached, and causing the resultant pain anddiscomfort to the patient.

[0063] It is not necessary to advance the colonoscope all the waythrough the sigmoid colon to the proximal end of the descending colonbefore beginning the reduction of the sigmoid colon using the device ofthe invention.

[0064] The device of the invention may be used to aid advancement of acolonoscope through a colon while insufflating the colon distally of thecolonoscope. The anchoring of the interior wall of the colon to thedevice proximally of the insufflation aperture prevents the insufflationfluid from leaking proximally and in this manner an effective, higherpressure insufflation of the colon is achieved.

BRIEF DESCRIPTION OF THE DRAWINGS

[0065] The invention will be more clearly understood from the followingdescription of some embodiments thereof, given by way of example only,with reference to the accompanying drawings, in which:

[0066]FIG. 1 is a longitudinal, side view of a device according to theinvention passing over a colonoscope in a colon;

[0067]FIG. 2 is a longitudinal, side view of the interior wall of thecolon anchored to the device of FIG. 1;

[0068]FIG. 3(a) is a schematic view illustrating partial insertion of acolonoscope into a colon of a patient;

[0069]FIG. 3(b) is a schematic view illustrating partial insertion ofthe device of FIGS. 1 and 2 into the colon over the colonoscope;

[0070]FIG. 3(c) is a schematic view illustrating anchoring of theinterior wall of the colon to the device by suction;

[0071]FIG. 4 is a schematic view illustrating drawing of the colonproximally to partially straighten the sigmoid colon;

[0072]FIG. 5 is a schematic view illustrating advancing the colonoscopethrough the colon;

[0073]FIG. 6 is a schematic view illustrating releasing the anchor ofthe interior wall of the colon to the device;

[0074]FIG. 7 is a schematic view illustrating advancing the devicethrough the colon over the colonoscope;

[0075]FIG. 8 is a schematic view illustrating anchoring of the interiorwall of the colon to the device by suction;

[0076]FIG. 9 is a schematic view illustrating drawing of the colonproximally to partially straighten the sigmoid colon;

[0077] FIGS. 10 to 18 are schematic views, similar to FIGS. 3(a) to 9,illustrating straightening of the sigmoid colon using another deviceaccording to the invention;

[0078]FIG. 19 is a perspective view of another device according to theinvention in an uninflated configuration passing over the colonoscope;

[0079]FIG. 20 is a perspective view of the device of FIG. 19 in aninflated configuration passing over the colonoscope;

[0080]FIGS. 21 and 22 are views similar to FIGS. 19 and 20 of anotherdevice according to the invention passing over the colonoscope;

[0081]FIG. 23 is a perspective view of another device according to theinvention in an uninflated configuration passing over the colonoscope;

[0082]FIG. 24 is a perspective view of the device of FIG. 23 in aninflated configuration passing over the colonoscope;

[0083]FIGS. 25 and 26 are perspective views in the opposite direction ofthe device of FIGS. 23 and 24 passing over the colonoscope;

[0084]FIGS. 27 and 28 are partially cross-sectional, side views of thedevice of FIGS. 23 and 24 passing over the colonoscope;

[0085] FIGS. 29 to 34 are views similar to FIGS. 19 and 20 of otherdevices according to the invention passing over the colonoscope;

[0086]FIG. 35 is a perspective view of another device according to theinvention in an uninflated configuration passing over the colonoscope;

[0087]FIG. 36 is a partially cut-away, perspective view of the device ofFIG. 35 in the uninflated configuration passing over the colonoscope;

[0088]FIG. 37 is a partially cut-away, perspective view of the device ofFIG. 35 in an inflated configuration passing over the colonoscope;

[0089]FIG. 38 is a schematic view illustrating partial insertion of acolonoscope into a colon of a patient;

[0090]FIG. 39 is a schematic view illustrating partial insertion of thedevice of FIGS. 1 and 2 into the colon over the colonoscope;

[0091]FIG. 40 is a schematic view illustrating insufflating the colonafter anchoring the interior wall of the colon to the device by suction;

[0092]FIG. 41 is a schematic view illustrating advancing the colonoscopethrough the colon;

[0093]FIG. 42 is a schematic view illustrating advancing the devicethrough the colon over the colonoscope;

[0094]FIG. 43 is a schematic view illustrating insufflating the colonafter anchoring the interior wall of the colon to the device by suction;

[0095]FIG. 44 is a schematic view illustrating releasing the anchor ofthe interior wall of the colon to the device after advancing thecolonoscope through the colon; and

[0096] FIGS. 45 to 49 are schematic views, similar to FIGS. 38 to 42,illustrating advancing the colonoscope through the colon using thedevice of FIGS. 10 to 18.

DETAILED DESCRIPTION

[0097] Referring to the drawings, and initially to FIGS. 1 and 2thereof, there is illustrated a device 1 according to the invention foruse to aid advancement of a colonoscope 2 through a colon 3 of apatient.

[0098] The device 1 comprises an elongate body 4 which extends between aproximal end 5 for location externally of the colon 3 and a distal end 6for insertion into the colon 3. The body 4 defines a colonoscope lumen 7therethrough for passing the body 4 over the colonoscope 2, and the body4 comprises a fluid-tight distal seal 11 between the body 4 and thecolonoscope 2 at the distal end 6 of the body 4, and a fluid-tightproximal seal 12 between the body 4 and the colonoscope 2 at theproximal end 5 of the body 4.

[0099] The seals 11, 12 prevent material such as faeces, bodily fluids,or parts of the colon wall from entering the colonoscope lumen 7 betweenthe colonoscope 2 and the body 4, and possibly leaking proximallythrough the lumen 7 and out of the colon 3 during the colonoscopyprocedure.

[0100] The distal seal 11 also prevents parts of the interior wall ofthe colon 3 from becoming snagged or caught on the distal end 6 of thebody 4, or trapped in the colonoscope lumen 7, or in any other waydamaged, as the body 4 is advanced through the colon 3.

[0101] The body 4 comprises an anchor to releasably anchor the interiorwall of the colon 3 to the device 1. By anchoring the interior wall ofthe colon 3 to the device 1, and holding the device 1 in position, thisenables the colonoscope 2 to be more easily advanced through the colon3.

[0102] In this case, the anchor is provided by a plurality of suctionapertures 8 in the body 4 adjacent the distal end 6 of the body 4. Asuction lumen, which is in fluid communication with the suctionapertures 8, extends proximally from the suction apertures 8 to theproximal end 5 of the body 4, where the suction lumen is connected influid communication with a source of negative gauge pressure, forexample via a tubing 9.

[0103] By applying suction at the suction apertures 8, the interior wallof the colon 3 may be drawn into an anchored engagement with the body 4,as illustrated in FIG. 2.

[0104] The apertures 8 have a cylindrical cross-section with a taperedlead-in, as illustrated in FIGS. 1 and 2. Alternatively, the apertures 8may have a cylindrical cross-section, or a rounded cross-section, or anysuitable combination of these cross-sections.

[0105] The apertures 8 are preferably spaced evenly around the body 4and along the body 4, as illustrated in FIGS. 1 and 2, for an evenanchored engagement of the body 4 with the interior wall of the colon 3.

[0106] By maximising the number of suction apertures 8, the requiredsuction pressure at each aperture 8 may be minimised, and thus thepossibility of damaging the interior wall of the colon 3 is minimised.

[0107] The suction lumen is preferably provided by the colonoscope lumen7. In this case, the seals 11, 12 ensure no fluid leakage occurs at theseals 11, 12 so that an effective and secure suction is applied at theapertures 8.

[0108] In use, a distal end 10 of the colonoscope 2 is inserted into thecolon 3, and the colonoscope 2 is advanced through the colon 3 until thedistal end 10 of the colonoscope 2 has encountered an obstruction tofurther advancement through the colon 3, for example when the distal end10 of the colonoscope 2 has reached the proximal end of the sigmoidcolon (FIG. 3(a)).

[0109] The distal end 6 of the body 4 is inserted into the colon 3 andadvanced over the colonoscope 2 until the distal end 6 of the body 4 isimmediately proximally of the distal end 10 of the colonoscope 2 (FIG.3(b)). Suction is then applied at the suction apertures 8 to anchor theinterior wall of the colon 3 to the device 1 by drawing the interiorwall of the colon into an anchored engagement with the body 4 (FIG.3(c)).

[0110] By holding the device 1 in position, the anchored colon 3 willalso be held in position. The colonoscope 2 may then be advanced moreeasily through the colon 3.

[0111] In this case, the method also includes the step of moving thebody 4 proximally, to draw the anchored colon 3 proximally to partiallystraighten the sigmoid colon (FIG. 4).

[0112] In this case, the colonoscope 2 is retracted with the body 4during straightening of the sigmoid colon. However, it will beappreciated that the colonoscope 2 may alternatively be held in placeduring movement of the body 4 only proximally, to straighten the sigmoidcolon 3.

[0113] The colonoscope 2 is then advanced further distally through partof the now partially straightened sigmoid colon (FIG. 5), and thesuction applied at the suction apertures 8 is released to release theanchor of the interior wall of the colon 3 to the body 4 (FIG. 6). Thedevice 1 is thus free to be advanced distally through the colon 3 overthe colonoscope 2 until the distal end 6 of the body 4 is immediatelyproximally of the distal end 10 of the colonoscope 2 (FIG. 7).

[0114] The interior wall of the colon 3 is gripped by applying suctionat the suction apertures 8 (FIG. 8), and the colonoscope 2 and body 4are moved proximally together to draw the colon 3 proximally to furtherstraighten the sigmoid colon (FIG. 9).

[0115] As is clear from the drawings, and FIG. 8 in particular, thelocation of anchoring of the interior wall of the colon 3 to the device1 has progressed distally from the initial anchoring locationillustrated in FIG. 3 to the next anchoring location illustrated in FIG.8.

[0116] The series of steps described previously with reference to FIGS.3(a) to 9 may thus be repeated to advance the colonoscope 2 through thecolon 3 in an incremental manner, and possibly additionally tostraighten the sigmoid colon in an incremental manner, each timeprogressing the location of anchoring of the interior wall of the colon3 to the device 1 successively distally.

[0117] When the device 1 is used to straighten a sigmoid colon thedevice 1 may be advanced until the distal end 6 of the body 4 is at theproximal end of the descending colon. The device 1 may thus be used asan overtube to splint the straightened sigmoid colon. The colonoscope 2may be advanced into the descending colon and further on into thetransverse colon and into the ascending colon. The device 1 preventsloops from reforming in the sigmoid colon as the colonoscope 2 advancesthrough the colon 3.

[0118] It will be appreciated by those skilled in the art that thedevice 1 of the invention may be used with a colonoscope 2 to reduce asigmoid colon to a straightened configuration in an incremental mannerby repeating the steps, described previously with reference to FIGS. 5to 9, a sufficient number of times until the sigmoid colon isstraightened. The number of times the steps need to be performed dependson the physiological characteristics of the patient on whom thecolonoscopy is being performed. In certain cases, it may only requireone reduction to straighten the sigmoid colon sufficiently for a smooth,pain-free advancement of the colonoscope 2 through the sigmoid colon tothe proximal end of the descending colon.

[0119] The first location of anchoring of the interior wall of the colon3 to the device 1 may be proximally of the sigmoid colon depending onthe physiological characteristics of the patient, and may even be in theregion of the rectum.

[0120] It is believed that anchoring the interior wall of a colon 3 bymeans of suction results in a secure anchor of the colon wall to thedevice 1 without causing discomfort to the patient.

[0121] Referring to FIGS. 10 to 18, there is illustrated another device20 according to the invention, which is similar to the device 1 of FIGS.1 to 9, and similar elements in FIGS. 10 to 18 are assigned the samereference numerals.

[0122] The anchor is provided by at least one outwardly movable member.The member may be expandable outwardly, and is preferably inflatableinto an anchored engagement with the interior wall of the colon 3. Inthis case, the anchor comprises a balloon 21 annularly mounted adjacentthe distal end 6 of the body 4, as illustrated in FIG. 11.

[0123] The balloon 21 may be of silicone, or of an elasticated filmmaterial.

[0124] An inflation lumen, which is in fluid communication with theballoon 21, extends proximally from the balloon 21 to the proximal end 5of the body 4, where the lumen is connected in fluid communication withan inflation fluid source, for example via the tubing 9.

[0125] The inflation lumen is preferably provided by the colonoscopelumen 7.

[0126] Inflation of the balloon 21 expands the balloon 21 outwardly intoan anchored engagement with the interior wall of the colon 3, asillustrated in FIG. 12.

[0127] The longitudinal length of the balloon 21 may be selected toachieve a desired anchoring between the colon 3 and the balloon 21.

[0128] FIGS. 10 to 18 illustrate the device 20 being used with thecolonoscope 2 to advance the colonoscope 2 through the colon 3, and inthis case also to straighten the sigmoid colon, in a manner similar tothat described previously with reference to FIGS. 1 to 9. In the case ofFIGS. 10 to 18, the device 20 is anchored to the interior wall of thecolon 3 by inflation of the balloon 21 to expand the balloon 21outwardly into an anchored engagement with the interior wall of thecolon 3 (FIGS. 12 and 17), and the device 20 releases the anchor of theinterior wall of the colon 3 to the device 20 by deflating the balloon21 (FIG. 15).

[0129] It will be appreciated that the anchor of the device of theinvention may be provided by one or more arrays of suction apertures 8,as described previously with reference to FIGS. 1 to 9, or by one ormore outwardly moveable members, such as the inflatable balloon 21, asdescribed previously with reference to FIGS. 10 to 18, or by one or morearrays of suction apertures 8 in combination with one or more outwardlymoveable members.

[0130] Referring now to FIGS. 19 and 20, there is illustrated anotherdevice 101 according to the invention, which is similar to the device 20of FIGS. 10 to 18, and similar elements in FIGS. 19 and 20 are assignedthe same reference numerals.

[0131] In this case, the anchor comprises an absorber, the absorberengaging with the interior wall of the colon 3 upon inflation of theballoon 21 into the anchored engagement with the interior wall of thecolon 3.

[0132] It is believed that the absorber absorbs some of the fluidsand/or faeces from the colon 3 in the region of anchoring of theinterior wall of the colon 3 to the device 101, and in this manner amore secure anchoring engagement is achieved.

[0133] The absorber is provided, in this case, by three hoops 100 of aporous material, such as a sponge or a foam, mounted directly to theballoon 21, such as by an adhesive. The hoops 100 extend around theballoon 21, as illustrated in FIG. 20.

[0134] The device 101 further comprises a movable sheath 102 which maybe positioned around the absorption hoops 100 to separate the absorptionhoops 100 from the interior wall of the colon 3 during insertion andremoval of the device 101 from the colon 3. In this way, the device 101can be inserted into the colon 3 and removed from the colon 3 with lessfrictional resistance. Prior to balloon inflation, the sheath 102 isretracted to reveal the absorption hoops 100.

[0135] It will be appreciated that the absorber is suitable, in use, toenhance the anchoring engagement between the interior wall of the colon3 with a cylindrical balloon 21, as illustrated in FIGS. 19 and 20, or aspherical balloon 112, as illustrated in FIGS. 21 and 22, or any othertype of balloon.

[0136] FIGS. 23 to 28 illustrate another device 120 according to theinvention, which is similar to the device 101 of FIGS. 19 and 20, andsimilar elements in FIGS. 23 to 28 are assigned the same referencenumerals.

[0137] In this case, the absorber is provided by a plurality of strips121 of porous material which extend longitudinally along the sphericalballoon 112. The strips 121 are mounted to the body 4 by means of adistal collar 122 and a proximal collar 123. The distal collar 122 isfixed to the body 4, and the proximal collar 123 is slidable distallyover the body 4 as the balloon 112 is inflated from the uninflatedconfiguration (FIGS. 23, 25, 27) to the inflated configuration (FIGS.24, 26, 28). Upon deflation of the balloon 112, the proximal collar 123slides proximally back to the uninflated configuration.

[0138] Referring to FIGS. 29 and 30, there is illustrated another device130 according to the invention, which is similar to the device 120 ofFIGS. 23 to 28, and similar elements in FIGS. 29 and 30 are assigned thesame reference numerals.

[0139] The absorber is provided, in this case, by a plurality of strips131 of porous material which extend in a spiral along the sphericalballoon 112. The strips 131 are connected to the proximal ring 123 bymeans of a plurality of resilient bands 132. The proximal ring 123 isfixed to the body 4, in this case, such that the bands 132 bias thestrips 131 inwardly to a low-profile configuration (FIG. 29) for ease ofinsertion and removal of the device 130 from the colon 3.

[0140] FIGS. 31 to 37 illustrate further devices 140, 150, 160 accordingto the invention, which are similar to the device 101 of FIGS. 19 and20, and similar elements in FIGS. 31 to 37 are assigned the samereference numerals.

[0141] In the case of the device 140 of FIGS. 31 and 32, the absorber isprovided by a plurality of pads 141 or blocks of porous materialadhesively fixed to the spherical balloon 112. In the device 150 ofFIGS. 33 and 34, the absorber 151 is adhesively fixed around thespherical balloon 112 to surround the balloon 112. A plurality ofopenings are provided in the absorber 151.

[0142] In FIGS. 35 to 37, the device 160 comprises a spherical absorber161 which forms a continuous enclosure surrounding the balloon 112. Asillustrated in FIGS. 36 and 37, the absorber 161 is biased to extendoutwardly in both the inflated and uninflated configurations. Howeverwhen the balloon 112 is deflated, the absorber 161 is relativelyflexible and may be collapsed down around the deflated balloon 112 for alow-profile.

[0143] The absorber may be of any suitable porous material, preferablyof open cell construction, for example a polymeric material, such aspolyurethane.

[0144] It will be appreciated that an absorber, similar to thatdescribed previously with reference to FIGS. 19 to 37, may be used withthe device 1 described previously with reference to FIGS. 1 to 9 toenhance the anchoring engagement of the interior wall of the colon 3 tothe body 4.

[0145] Referring next to FIGS. 38 to 44, the device 1 of the invention,which was described previously with reference to FIGS. 1 to 9, isillustrated in use aiding advancement of a colonoscope 40 through thecolon 3.

[0146] The colonoscope 40 defines a proximal end for location externallyof the colon 3 and a distal end 42 for insertion into the colon 3.

[0147] The colonoscope 40 comprises an insufflation means at the distalend 42 of the colonoscope 40 for insufflating the colon 3 distally ofthe colonoscope 40 to clear a passage for advancement of the colonoscope40 through the colon 3. In this case, the insufflation means comprisesat least one insufflation aperture 43 in the colonoscope 40 at thedistal end 42 of the colonoscope 40, the aperture 43 being in fluidcommunication with at least one insufflation lumen. The insufflationlumen extends proximally through the colonoscope 40 to the proximal endof the colonoscope 40, where the lumen is connected in fluidcommunication with an insufflation fluid source.

[0148] In use, the distal end 42 of the colonoscope 40 is inserted intothe colon 3, and the colonoscope 40 is advanced through the colon 3until the distal end 42 of the colonoscope 40 encounters an obstructionto further advancement of the colonoscope 40 through the colon 41, suchas a tight bend in the sigmoid colon, as illustrated in FIG. 38. It isnot possible to easily advance the colonoscope 40 any further distallythrough this tight bend in the sigmoid colon.

[0149] The distal end 6 of the body 4 is inserted into the colon 3, andthe body 4 is advanced over the colonoscope 40 until the distal end 6 ofthe body 4 is immediately proximally of the distal end 42 of thecolonoscope 40 (FIG. 39)

[0150] The interior wall of the colon 3 is anchored to the device 1 byapplying suction at the suction apertures 8 to draw the interior wall ofthe colon 3 into an anchored engagement with the body 4. By holding thedevice 1 in position, the anchored colon 3 will also be held inposition. The colonoscope 40 may then be advanced more easily throughthe colon 3.

[0151] In this case, the method also includes the step of passinginsufflation fluid from the insufflation fluid source through theinsufflation lumen in the colonoscope 40 and out of the insufflationaperture 43 to insufflate the colon 3 distally of the colonoscope 40(FIG. 40). The insufflation action helps to open up the bend in thecolon 3 and in this way clears a passage for further advancement of thecolonoscope 40 through the colon 3 (FIG. 41).

[0152] By anchoring the interior wall of the colon 3 to the body 4, thisalso creates a fluid-tight seal between the interior wall of the colon 3and the body 4.

[0153] By creating the seal proximally of the insufflation aperture 43,this ensures that no insufflation fluid can leak proximally over thecolonoscope 40. In this manner, the full effect of the insufflation isdirected distally to effectively clear a passage for advancement of thecolonoscope 40 through the colon 3, as illustrated in FIG. 41.

[0154] The seals 11, 12 also prevent insufflation fluid from leakingproximally between the colonoscope 40 and the body 4.

[0155] Insufflation of the colon 41 may be stopped before furtheradvancement of the colonoscope 40, alternatively the insufflation maycontinue during the advancement of the colonoscope 40 to ensure anunobstructed passage through the colon 3.

[0156] During this further advancement of the colonoscope 40 through thenow cleared colon 3, the anchor between the body 4 and the interior wallof the colon 3 is maintained, and in this way the seal between the body44 and the colon 3 is also maintained.

[0157] After the colonoscope 40 has been advanced further, the anchoringof the body 4 to the interior wall of the colon 3 may be released byreleasing the suction.

[0158] The colonoscope 40 is advanced through the colon 3 until anotherobstruction to further advancement of the colonoscope 40 is encountered,such as a tight bend in the sigmoid colon, as illustrated in FIG. 41.The body 4 is then advanced until the distal end 6 of the body 4 isimmediately proximally of the distal end 42 of the colonoscope 40 (FIG.42). The interior wall of the colon 3 is anchored to the body 4 byapplying suction at the suction apertures 8, and the colon 3 isinsufflated distally of the colonoscope 40 to open up the bend and cleara passage for further advancement of the colonoscope 40 through thecolon 3 (FIG. 43), in a manner similar to that described previously withreference to FIG. 40.

[0159] The colonoscope 40 is then advanced further distally through thecolon 3 unobstructed, after which the anchoring of the body 4 to theinterior wall of the colon 3 may be released by releasing the suction(FIG. 44).

[0160] This procedure may be repeated to clear a passage for advancementof the colonoscope 40 through the colon 3 each time an obstruction isencountered. As illustrated in FIGS. 38 to 44, as the procedure isrepeated through the colon 3, the point of anchoring of the body 4 tothe interior wall of the colon 3 progresses successively distally.

[0161] When the colonoscope 40 has been advanced through a colon 3 untilthe distal end 42 of the colonoscope 40 is at the proximal end of thedescending colon (FIG. 44), the sigmoid colon may be straightened bymanipulating and/or torquing the colonoscope 40 in a manner known tothose skilled in the art.

[0162] The device 1 is then advanced over the colonoscope 40 until thedistal end 6 of the body 3 is immediately proximally of the distal end42 of the colonoscope 40 which is in the descending colon.

[0163] The device 1 then may act as a splint to maintain the floppysigmoid colon in the straightened configuration, and thus thecolonoscope 40 may be advanced further distally through the descendingcolon, into the transverse colon, and into the ascending colon withoutcausing pain and/or discomfort to the patient.

[0164] It is believed that anchoring the interior wall of the colon 3 bymeans of suction results in a secure anchor of the colon wall to thedevice 1 without causing discomfort to the patient.

[0165] Referring to FIGS. 45 to 49, the device 20 of the invention,which was described previously with reference to FIGS. 10 to 18, isillustrated in use aiding advancement of the colonoscope 40 through thecolon 3 in a manner similar to that described with reference to FIGS. 38to 44.

[0166] In use, the interior wall of the colon 3 is anchored to thedevice 20 by passing inflation fluid from the inflation fluid sourcethrough the tubing 9 into the inflation lumen, through the inflationlumen and into the balloon 21 to inflate the balloon 21 outwardly intoan anchored engagement with the interior wall of the colon 3 (FIG. 47).

[0167] The anchoring of the body 4 to the interior wall of the colon 3is subsequently released by deflating the balloon 21 to move the balloon21 inwardly.

[0168] It is believed that the use of an absorber, as describedpreviously with reference to FIGS. 19 to 37, also enhances the sealingof the balloon 21 to the interior wall of the colon 3.

[0169] The procedure for advancing a colonoscope through a colon hasbeen described in detail and illustrated in FIGS. 3(a) to 49 in relationto advancement of the colonoscope through the sigmoid colon. It will ofcourse be appreciated that the device of the invention is suitable foraiding advancement of a colonoscope through any part of the colon.

[0170] It will further be appreciated that the straightening procedure,as described previously with reference to FIGS. 3(a) to 18, may be usedin combination with the insufflation procedure, as described previouslywith reference to FIGS. 38 to 49.

[0171] The invention is not limited to the embodiments hereinbeforedescribed, with reference to the accompanying drawings, which may bevaried in construction and detail.

1. A device to aid advancement of a colonoscope through a colon, thedevice comprising: an elongate body extending between a proximal end forlocation externally of a colon and a distal end for insertion into acolon; the body defining a colonoscope lumen therethrough, and an anchorto releasably anchor the interior wall of a colon to the device.
 2. Adevice as claimed in claim 1 wherein the anchor comprises at least onesuction aperture in the body to draw the interior wall of a colon intoan anchored engagement with the body by suction.
 3. A device as claimedin claim 2 wherein the anchor comprises a plurality of suctionapertures.
 4. A device as claimed in claim 3 wherein the apertures areevenly spaced around the body.
 5. A device as claimed in claim 3 whereinthe apertures are evenly spaced along the body.
 6. A device as claimedin claim 2 wherein the anchor comprises at least one suction lumen influid communication with the suction aperture.
 7. A device as claimed inclaim 6 wherein the suction lumen extends proximally from the suctionaperture to the proximal end of the body.
 8. A device as claimed inclaim 6 wherein the suction lumen is provided by the colonoscope lumen.9. A device as claimed in claim 2 wherein the anchor comprises a sourceof negative gauge pressure in fluid communication with the suctionaperture.
 10. A device as claimed in claim 1 wherein the anchorcomprises at least one member which is moveable outwardly into ananchored engagement with the interior wall of a colon.
 11. A device asclaimed in claim 10 wherein the member is expandable into an anchoredengagement with the interior wall of a colon.
 12. A device as claimed inclaim 11 wherein the member is inflatable into an anchored engagementwith the interior wall of a colon.
 13. A device as claimed in claim 12wherein the inflatable member comprises a balloon.
 14. A device asclaimed in claim 12 wherein the anchor comprises at least one inflationlumen in fluid communication with the inflatable member.
 15. A device asclaimed in claim 14 wherein the inflation lumen extends proximally fromthe inflatable member to the proximal end of the body.
 16. A device asclaimed in claim 14 wherein the inflation lumen is provided by thecolonoscope lumen.
 17. A device as claimed in claim 12 wherein theanchor comprises an inflation fluid source in fluid communication withthe inflatable member.
 18. A device as claimed in claim 1 wherein theanchor comprises an absorber.
 19. A device as claimed in claim 18wherein the absorber is mounted to the elongate body.
 20. A device asclaimed in claim 19 wherein the absorber is biased inwardly.
 21. Adevice as claimed in claim 19 wherein the absorber is biased outwardly.22. A device as claimed in claim 18 wherein the absorber is mounted toor comprises the movable member.
 23. A device as claimed in claim 18wherein the absorber comprises at least one pad on the device.
 24. Adevice as claimed in claim 18 wherein the absorber comprises at leastone strip extending along the device.
 25. A device as claimed in claim24 wherein the strip extends substantially longitudinally.
 26. A deviceas claimed in claim 24 wherein the strip extends substantially in aspiral or part thereof.
 27. A device as claimed in claim 18 wherein theabsorber comprises at least one hoop extending around the device.
 28. Adevice as claimed in claim 18 wherein the absorber surrounds the anchor.29. A device as claimed in claim 28 wherein the absorber has a pluralityof openings therein.
 30. A device as claimed in claim 28 wherein theabsorber is a continuous enclosure around the anchor.
 31. A device asclaimed in claim 18 wherein the absorber is of a porous material.
 32. Adevice as claimed in claim 31 wherein the porous material is of an opencell construction.
 33. A device as claimed in claim 31 wherein theporous material is of a polymeric material.
 34. A device as claimed inclaim 18 wherein the device comprises a sleeve to separate the absorberfrom the interior wall of a colon during insertion and removal of thedevice.
 35. A device as claimed in claim 34 wherein the sleeve comprisesa movable sheath.
 36. A device as claimed in claim 1 wherein the anchoris provided adjacent the distal end of the body.
 37. A device as claimedin claim 1 wherein the body comprises at least one seal for sealingbetween the body and a colonoscope within the colonoscope lumen.
 38. Adevice as claimed in claim 37 wherein the seal is a fluid-tight seal.39. A device as claimed in claim 37 wherein the seal is provided at anend of the body.
 40. A device as claimed in claim 39 wherein the bodycomprises a distal seal at the distal end of the body and a proximalseal at the proximal end of the body.
 41. A colonoscopy apparatus, theapparatus comprising: a device to aid advancement of a colonoscopethrough a colon, the device comprising: an elongate body extendingbetween a proximal end for location externally of a colon and a distalend for insertion into a colon; the body defining a colonoscope lumentherethrough, and an anchor to releasably anchor the interior wall of acolon to the device; and a colonoscope defining a proximal end forlocation externally of a colon and a distal end for insertion into acolon.
 42. An apparatus as claimed in claim 41 wherein the colonoscopecomprises an insufflation means at the distal end of the colonoscope toinsufflate a colon distally of the colonoscope to clear a passage foradvancement of the colonoscope through the colon.
 43. An apparatus asclaimed in claim 42 wherein the insufflation means comprises at leastone insufflation aperture in the colonoscope.
 44. An apparatus asclaimed in claim 43 wherein the insufflation means comprises at leastone insufflation lumen in fluid communication with the insufflationaperture.
 45. An apparatus as claimed in claim 44 wherein theinsufflation lumen extends proximally from the insufflation aperture tothe proximal end of the colonoscope.
 46. An apparatus as claimed inclaim 43 wherein the insufflation means comprises an insufflation fluidsource in fluid communication with the insufflation aperture.
 47. Anapparatus as claimed in claim 42 wherein the apparatus comprises asealing means to create a fluid-tight seal to the interior wall of acolon proximally of the distal end of the colonoscope duringinsufflation.
 48. An apparatus as claimed in claim 47 wherein thesealing means is provided by the anchor.
 49. A method of advancing acolonoscope through a colon, the method comprising the steps of:providing a colonoscope, the colonoscope defining a proximal end and adistal end; providing an anchoring device, the anchoring device defininga proximal end and a distal end; inserting the distal end of thecolonoscope into a colon; inserting the distal end of the anchoringdevice into the colon; anchoring the interior wall of the colon to theanchoring device; advancing the colonoscope through at least part of thecolon; and releasing the anchor.
 50. A method as claimed in claim 49wherein the method comprises the step of moving the anchoring deviceproximally to at least partially straighten the colon after anchoringthe interior wall of the colon to the anchoring device.
 51. A method asclaimed in claim 50 wherein the method comprises the step of moving thecolonoscope proximally during the step of moving the anchoring deviceproximally.
 52. A method as claimed in claim 50 wherein the methodcomprises the step of maintaining the position of the colonoscope fixedduring the step of moving the anchoring device proximally.
 53. A methodas claimed in claim 49 wherein the method comprises the step ofinsufflating the colon distally of the colonoscope to clear a passagefor advancement of the colonoscope through the colon.
 54. A method asclaimed in claim 53 wherein the method comprises the step of creating afluid-tight seal to the interior wall of the colon proximally of thedistal end of the colonoscope before insufflating the colon.
 55. Amethod as claimed in claim 54 wherein the seal to the interior wall ofthe colon is created by the step of anchoring the interior wall of thecolon to the anchoring device.
 56. A method as claimed in claim 49wherein the interior wall of the colon is anchored to the anchoringdevice by applying suction to draw the interior wall of the colon intoan anchored engagement with the anchoring device.
 57. A method asclaimed in claim 56 wherein the anchor is released by releasing thesuction.
 58. A method as claimed in claim 49 wherein the interior wallof the colon is anchored to the anchoring device by moving at least partof the anchoring device outwardly into an anchored engagement with theinterior wall of the colon.
 59. A method as claimed in claim 58 whereinthe part of the anchoring device is moved outwardly by inflation.
 60. Amethod as claimed in claim 58 wherein the anchor is released by movingthe part of the anchoring device inwardly.
 61. A method as claimed inclaim 49 wherein the method comprises the step of absorbing fluid fromthe colon using the anchoring device.
 62. A method as claimed in claim49 wherein the method comprises the step of advancing the colonoscopethrough the colon until the distal end of the colonoscope encounters anobstruction to further advancement of the colonoscope through the colonbefore anchoring the interior wall of the colon to the anchoring device.63. A method as claimed in claim 62 wherein the colonoscope is advancedthrough the colon until the distal end of the colonoscope is at theproximal end of the sigmoid colon before anchoring the interior wall ofthe colon to the anchoring device.
 64. A method as claimed in claim 49wherein at least some of the steps are repeated at least once to advancethe colonoscope through the colon in an incremental manner.
 65. A methodas claimed in claim 64 wherein the location of anchoring of the interiorwall of the colon to the anchoring device progresses successivelydistally as the steps are repeated.
 66. A method as claimed in claim 49wherein the anchoring device is passed over the colonoscope.
 67. Amethod as claimed in claim 66 wherein the anchoring device is passedover the colonoscope in a sealed manner.
 68. A method of advancing acolonoscope through a sigmoid colon the method comprising the steps of:providing a colonoscope, the colonoscope defining a proximal end and adistal end; providing an anchoring device, the anchoring device defininga proximal end and a distal end; inserting the distal end of thecolonoscope into a sigmoid colon; inserting the distal end of theanchoring device into the sigmoid colon; anchoring the interior wall ofthe sigmoid colon to the anchoring device; advancing the colonoscopethrough at least part of the sigmoid colon; and releasing the anchor.69. A method of straightening a sigmoid colon as claimed in claim 68wherein the method comprises the step of moving the anchoring deviceproximally to at least partially straighten the sigmoid colon afteranchoring the interior wall of the sigmoid colon to the anchoringdevice.
 70. A method as claimed in claim 69 wherein the method comprisesthe steps of: advancing the anchoring device until the distal end of theanchoring device is at the proximal end of the descending colon tosplint the straightened sigmoid colon; and advancing the colonoscopeinto the descending colon.